{
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"MailingAddressFaxNumber": "781-596-3966",
"FirstLinePracticeLocationAddress": "269 UNION ST",
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"EnumerationDate": "12/23/2021",
"LastUpdateDate": "08/05/2025",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SULLIVAN",
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"Taxonomies": {
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{
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"PrimaryTaxonomySwitch": "N"
},
{
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}
]
},
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}
}